<div class="center_title_bar">Register with Laksala? It's free and easy to complete.</div>
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		<div class="top_prod_box_big"></div>
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    		<div class="details_big_box"> 
    			<div id="msgbox" style="display: none;"></div>  
				<table border="0" cellpadding="1" cellspacing="1" width="100%" style="line-height: 25px;">
					<tr>
						<td colspan="4"><h3>Personal Information</h3></td>
					</tr>
					<tr>
						<td width="30%">First Name</td>
						<td width="70%"><input type="text" name="fnm1" id="fnm1" value="" /><div id="msgfnm1" style="display: none;"></div></td>			
					</tr>
					<tr>
						<td>Last Name</td>
						<td><input type="text" name="fnm2" id="fnm2" value="" /><div id="msgfnm2" style="display: none;"></div></td>
					</tr>
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						<td>Street Address</td>
						<td><input type="text" name="add1" id="add1" value="" /><div id="msgadd1" style="display: none;"></div></td>
					</tr>
					<tr>
						<td>&nbsp;</td>
						<td><input type="text" name="add2" id="add2" value="" /></td>
					</tr>
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						<td>City</td>
						<td><input type="text" name="city" id="city" value="" /><div id="msgcity" style="display: none;"></div></td>
					</tr>
					<tr>
						<td>Zip/Postal Code</td>
						<td><input type="text" name="postcd" id="postcd" value="" /><div id="msgpostcd" style="display: none;"></div></td>
					</tr>
					<tr>
						<td>Country</td>
						<td>
							<select name="country" id="country">
							<option value="">Select Country</option>
							{section name=country loop=$country_arr}
								<option value="{$country_arr[country].country_code}">{ucfirst($country_arr[country].country_name)}</option>
							{/section}
							</select><div id="msgcountry" style="display: none;"></div>
						</td>
					</tr>
					<tr>
						<td>Primary Telephone No.</td>
						<td><input type="text" name="phone1" id="phone1" value="" size="3" maxlength="3" onkeyup="autoFocus(this, 'phone2');" style="width: 50px;" /> - <input type="text" name="phone2" id="phone2" size="3" maxlength="3" onkeyup="autoFocus(this, 'phone3');" value="" style="width: 50px;" /> - <input type="text" name="phone3" id="phone3" size="4" maxlength="4" value="" style="width: 50px;" />&nbsp;&nbsp;ext: <input type="text" name="ext" id="ext" value="" style="width: 50px;" /><div id="msgcountry" style="display: none;"></div></td>
					</tr>					
					<tr>
						<td colspan="2"><h3>Login Information</h3></td>
					</tr>
					<tr>
						<td>Email Address</td>
						<td><input type="text" name="email1" id="email1" value="" /></td>
					</tr>
					<tr>
						<td>Re-enter email address</td>
						<td><input type="text" name="email2" id="email2" value="" /></td>
					</tr>
					<tr>
						<td>Create Password</td>
						<td><input type="password" name="pwd1" id="pwd1" value="" /></td>
					</tr>
					<tr>
						<td>Re-enter your password</td>
						<td><input type="password" name="pwd2" id="pwd2" value="" /></td>
					</tr>
					<tr>
						<td>Pick a secret question</td>
						<td>
							<select name="sec_ques" id="sec_ques">
								<option value="">Select your secret question...</option>
								<option value="What street did you grow up on?">What street did you grow up on?</option>
								<option value="What is your mother's maiden name?">What is your mother's maiden name?</option>
								<option value="What is the name of your first school?">What is the name of your first school?</option>
								<option value="What is your pet's name?">What is your pet's name?</option>
								<option value="What is your father's middle name?">What is your father's middle name?</option>
								<option value="What is your school's mascot?">What is your school's mascot?</option>
							</select>
						</td>
					</tr>
					<tr>
						<td>Your secret answer</td>
						<td><input type="text" name="sec_ans" id="sec_ans" value="" /></td>
					</tr>
					<tr>
						<td colspan="2">&nbsp;</td>
					</tr>
					<tr>
						<td colspan="2"><input type="checkbox" name="agreed" id="agreed" value="1" /> I accept the <a href="javascript: void(0);" onclick="showAgreement();">User Agreement</a> and <a href="javascript: void(0);" onclick="privacyPolicy();">Privacy Policy</a></td>
					</tr>
					<tr>
						<td colspan="2"><a href="javascript: void(0);" onclick="newuser();"><img src="images/contbtn.png" border="0" /></a></td>
					</tr>
				</table>
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			</div>		
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